Dynamics of Erythropoietin Deficiency During the Progression of Chronic Kidney Disease: An Analysis from Stages I to V in Cameroonian Adults

Author(s): Elimby Ngande Lionel Patrick Joel, Nguea Ndjame Arlette and Fouda Menye Epouse Ebana Hermine Danielle

Background: Erythropoietin deficiency significantly contributes to the development of severe anemia, which in turn leads to therapeutic complications and significantly worsens the prognosis of patients with chronic kidney disease (CKD). Among Cameroonian adults, data on variations in erythropoietin concentrations in CKD patients are scarce. The aim of this study was to explore the dynamics of erythropoietin deficiency during the progression of chronic kidney disease from stages I to V in Cameroonian adults.

Methods: We conducted an analytical cross-sectional study in the nephrology department of the Douala General Hospital over a sixmonth period. A total of 262 patients with CKD at various stages were included. Glomerular filtration rate (GFR), creatinine, and erythropoietin concentrations were measured. One-way analysis of variance (ANOVA) and the Kruskal-Wallis rank sum test were used to compare mean erythropoietin concentrations across CKD stages.

Results: The mean age of the patients was 49 ± 14 years, ranging from 17 to 78 years. The majority were male (60%, n = 157), married (63%, n = 148), and worked in the informal sector (48%, n = 103). Mean erythropoietin levels decreased progressively and significantly across CKD stages: stage I (4.62 ± 2.19 mIU/mL), stage II (3.36 ± 2.06 mIU/mL), stage III (1.86 ± 1.50 mIU/mL), stage IV (0.99 ± 0.58 mIU/mL), and stage V (0.63 ± 0.29 mIU/mL) (P < 0.001).

Conclusion: Our study shows that among Cameroonian adults with CKD, erythropoietin deficiency begins early and progresses from stage II onward, leading to an approximate 86% reduction in serum erythropoietin levels between stages I and V.